Skip to main content Skip to main navigation menu Skip to site footer

Pregnancy with seropositive toxoplasmosis: a case report

Abstract

Introduction: Toxoplasmosis is present in every country and seropositive rates vary between regions from less than 10% to more than 90%. Toxoplasmosis in pregnancy can result in severe sequelae to the fetus. Primary infection in pregnancy may cause spontaneous abortion or fetal death in utero. Congenital ocular and neurological abnormalities may also occur. We present a case involving toxoplasmosis infection in early pregnancy and an overview of the management and the clinical outcomes for both mother and fetus.

Case report: A 26-year-old pregnant woman (G1P0A0) showed a high concentration of IgG anti-toxoplasmosis in early pregnancy with a concentration of 1200. Throughout the pregnancy, an increase in the concentration of IgG anti-toxoplasma was found. At 14 weeks gestation, concentration increased four-fold to 9068. During the ultrasound observation no hydrocephalus, ocular, and neurological abnormalities were found. Amniocentesis was performed for PCR examination and the result turned out negative. The patient was given spiramycin 1 gram daily for the remaining of her pregnancy. At 40 weeks gestation, the patient gave birth vaginally to a healthy term 3700 grams baby boy. There were no signs of major anomalies found in the baby.

Conclusions: Diagnosis and screening of toxoplasmosis require proper understanding of serological examination, as well as the specificity and sensitivity of the diagnostic tools. Ultrasound monitoring for the detection of congenital toxoplasmosis can also help with diagnosis.

References

  1. Torgerson PR, Mastroiacovo P. The global burden of congenital toxoplasmosis: a systematic review. Bulletin of the World Health Organization. 2013;91(‎7)‎:501-508.
  2. Nissapatorn V. Toxoplasmosis: A Silent threat in Southeast Asia. Research Journal Parasitology. 2007;2(1):1-1.
  3. Gandahusada S. Study on the prevalence of toxoplasmosis in Indonesia: a review. Southeast Asian J Trop Med Public Health. 1991;12(2):93-8.
  4. Eka NP, Indriani C, Artama WT. Seroprevalence of toxoplasmosis in Gianyar Regency. BKM Journal of Community Medicine and Public Health. 2017;33:61-65.
  5. Foulon W, Naessens A, Ho-Yen D. Prevention of congenital toxoplasmosis. Journal of Perinatal Medicine. 2000;28;337-345.
  6. McAuley JB. Congenital Toxoplasmosis. Journal of the Pediatric Infectious Diseases Society 2014;3:S30–S35.
  7. Robert-Gangneux F, Murat J-B, Fricker-Hidalgo H, Brenier-Pinchart M-P, Gangneux J-P, Pelloux H. The placenta: a main role in congenital toxoplasmosis? Trends in Parasitology.2011;27:530–536.
  8. Kimura Y, Haneda S, Aoki T, Furuoka H, Miki W, Fukumoto N, et al. Combined thickness of the uterus and placenta and ultrasonographic examinations of uteroplacental tissues in normal pregnancy, placentitis, and abnormal parturitions in heavy draft horses. JES. 2018;29:1–8.
  9. Paquet C, Yudin MH, Yudin MH, Allen VM, Bouchard C, Boucher M, et al. Toxoplasmosis in Pregnancy: Prevention, Screening, and Treatment. Journal of Obstetrics and Gynaecology Canada. 2013;35:78–79.
  10. Pomares C, Montoya JG. Laboratory Diagnosis of Congenital Toxoplasmosis. J Clin Microbiol. 2016;54:2448–2454.
  11. Wallon M, Franck J, Thulliez P, Huissoud C, Peyron F, Garcia-Meric P et al. Accuracy of Real-Time Polymerase Chain Reaction for Toxoplasma gondii in Amniotic Fluid: Obstetrics & Gynecology. 2010;115:727–733.
  12. Bortoletti Filho J, Araujo Júnior E, Carvalho N da S, Helfer TM, Nogueira Serni P de O, Nardozza LMM, et al. The Importance of IgG Avidity and the Polymerase Chain Reaction in Treating Toxoplasmosis during Pregnancy: Current Knowledge. Interdisciplinary Perspectives on Infectious Diseases. 2013;2013:1–5.
  13. Montoya JG, Remington JS. Clinical Practice: Management of Toxoplasma gondii Infection during Pregnancy. Clin Infect Dis. 2008;47: 554–566.
  14. Remington JS, McLeod R, Wilson CB, Desmonts G. Toxoplasmosis. In: Infectious Diseases of the Fetus and Newborn. J Pediatric Infect Dis Soc. 2014; 3(Suppl 1):S30-S35.
  15. Schmidt DR, Hogh B, Andersen O, Hansen SH, Dalhoff K, Petersen E. Treatment of infants with congenital toxoplasmosis: tolerability and plasma concentrations of sulfadiazine and pyrimethamine. Eur J Pediatr. 2006;165:19–25.
  16. Fonseca ZC, Rodrigues IMX, Melo NC e, Avelar JB, Castro AM, Avelino MM. IgG Avidity Test in Congenital Toxoplasmosis Diagnoses in Newborns. Pathogens. 2017;6:26-31.

How to Cite

Darsana, N. Z., & Kusuma, A. A. N. J. (2020). Pregnancy with seropositive toxoplasmosis: a case report. Bali Medical Journal, 9(3), 599–604. https://doi.org/10.15562/bmj.v9i3.1971

HTML
0

Total
16

Share

Search Panel

Natassa Zefanya Darsana
Google Scholar
Pubmed
BMJ Journal


Anak Agung Ngurah Jaya Kusuma
Google Scholar
Pubmed
BMJ Journal